Education and Training as Intervention Strategies

There is a frequently told story in Indiana of a farmer who, during corn harvest, had his arm amputated when it became entangled in the plugged husking bed of an older model corn picker. Rather than shutting off the power to the picker, he left the tractor seat with the power takeoff engaged and attempted to unplug the operating husking bed using his gloved hand. His glove became caught between the husking rolls, pulling the farmer's hand and arm into the machine up to his elbow. It was several hours before he was discovered, and he had to be cut out of the machine by local emergency rescue personnel. His injuries required a lengthy hospitalization and rehabilitation as he learned to use his newly fitted Dorrance upper limb prosthesis. A year later, however, the farmer headed back to the field with his already well-used "farmer's hook" and the same tractor and corn picker. He proceeded to lose the other hand while again unplugging the husking bed without first shutting off power to the machine.

When this story is repeated to a farm audience, the response is almost always laughter with a few expressions of disbelief. It's hard for most people to imagine that anyone could go through an entanglement in a corn picker, amputation of his arm, and months of physical rehabilitation and not learn from his mistakes.

This type of incident, documented for many types of hazards in agriculture, is sometimes used by safety and health professionals to discredit the role of education as an effective prevention strategy in reducing the frequency and severity of agricultural injuries and disease. Using anecdotal, insufficient, or poorly interpreted data, safety and health professionals undermined the traditional "milking stool" model of safety introduced by Harvey in the early part of the 20th century (Figure 5.1) (1).

As the field of agricultural safety has moved from a cadre of professionals with primarily educational and engineering training to a predominance of individuals trained in epidemiology, medicine, public health, and other basic sciences, the supporting role of education has been replaced by "research-

Figure 5.1. Milking-stool approach to safety and health involving the "three E's." (Copyright WE. Field and R.L. Tormoehlen, used with permission.)

Figure 5.1. Milking-stool approach to safety and health involving the "three E's." (Copyright WE. Field and R.L. Tormoehlen, used with permission.)

based" initiatives to change public policy, regulations, and engineering standards. Some safety and health professionals have found Harvey's model philosophically bankrupt and largely irrelevant, motivating them to pursue more aggressively coercive approaches to behavior modification such as changing public opinion and regulations (1-6).

Has some new body of knowledge determined that education and training are no longer profitable tools for injury and disease prevention, or have other influences or special interests caused the role of education to be diminished in the field of agricultural safety and health? What has changed since Whitney (7) published his 1926 article, "The Fundamental Significance of Safety Education" or since Stevenson (8) argued that "the most important single factor . . . in our accident prevention movement is education"?

In the United States each year, approximately 750 farmers, ranchers, and agricultural workers, and their family members are killed and another 130,000 are injured as the result of attitudes or behaviors that they, in most cases, knew intellectually and experientially to be unsafe. In addition, others within this population, including children and newly hired workers, are injured by hazards of which they were ignorant. It is unlikely that there is a farmer or rancher in North America who doesn't know, for example, that handling anhydrous ammonia without adequate eye protection can lead to harmful consequences or that contacting an unguarded rotating shaft can cause injury. In fact, it can be convincingly argued that the majority of injuries on farms and ranches are caused by behaviors or actions that the victim knew at the moment had a higher probability of causing injury than what would be encountered through normal daily living (9,10). Recognizing that all hazards cannot be fully mitigated, those involved in prevention need to recognize the gap that exists between what is known about the causes of agricultural injuries and disease and how agricultural workers will act in any given circumstance. Neglecting the need to effectively transfer and reinforce safety and health information to those most vulnerable allows the problem to continue. Regardless of the advancements made in agricultural production technology, safety engineering, and safety and health regulations, education and training remain essential ingredients in the prevention of agricultural injuries and diseases (9,10).